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Dental Tribune United Kingdom Edition

19Endo TribuneApril 9-15, 2012United Kingdom Edition R4Practice Management Software GIVES YOU MORE AND KEEPS ON GIVING constantly improving constantly developing constantly delivering For more information or to place an order please call 0800 169 9692 email sales.uk.csd@carestream.com or visit www.carestreamdental.co.uk Carestream Dental © Carestream Dental Ltd., 2012. featuReS of R4 R4 Mobile Direct link to PIN pad Patient Check-in Kiosk Care Pathways Communicator Steritrak E-Forms Patient Journey On-line Appointment Booking Text Message and Email reminders Clinical Notes Appointment Book Digital X-Ray Managed Service Practice Accounts More features, More benefits, More time, More support, all of which can help you achieve More patients and More profits ...and there’s still more to come Dentistry is perched on a slip- pery slope. In North America alone, it represents a silo of ap- proximately $60 billion. Evidence- based science has been replaced by eminence-based science and the concept of “nonfiduciary ad- vocacy” has been lost in the ether. I wish I possessed Randy Lang’s erudition and Will Rogers’ wit. His recent editorial on a specific orthodontic band of dubious value beyond the strength of its market- ing showcased the fact that even amongst those whose focus is nar- rowed by a specialty, a segment can be catalysed through market forces to recognise something as the holy grail, when another faction sees the same product as having the value of a Gwyneth Paltrow GOOP-substantiated cleanse. In my own area of interest, a recent article by one of the bet- ter-known clinicians questioned the value of the wealth of new endodontic products coming to market, especially the latest NiTi iteration that reintroduced recip- rocation. The essence of the arti- cle was, “if it ain’t broke, don’t fix it”, which then included the take- away message that the product long associated with the reputa- tion of the author had served the discipline well and it too required only a paucity of instruments to achieve 100 per cent predictable clinical success. To bring this to a purposeful conclusion, I would encourage you to Google Bayes’ theorem. It is in essence an equation and de- pending upon whether you are a frequentist, a subjectivist or and objectivist, the theorem suggests that if we assign some a priori probabilities and then compute a posteriori probabilities, the degree of confidence in some hypotheses can be conditioned by the new data that becomes available. For example, the Venn diagram (Fig. 2) relates to a popu- lation, the number expected to have a type of cancer, the num- ber that are indeed positive for the cancer and the number that show a false positive by virtue of a test for markers. Alter the variable, consider the efficacy of lasers by way of example, the degree of penetration into the dental profession, the advocacy of those that use them and the perception of the value inherent based upon their need to see vi- able applications and substanti- ated results. It is a technology that will inevitably prove to be an invaluable tool, albeit cur- rently in its infancy. Read all publications with extreme caution – think HealO- zone. Dentistry is getting very complicated as technology and innovation alter its construct. The one essential aspect that must never be overlooked is the need to sustain biological fun- damentalism through assidu- ously conceived investigations and authorship that follows the Cochrane Collaborative prin- ciples. We are about to enter a decade wherein it is mani- festly conceivable that teeth can be regenerated or replicat- ed and achieve morphological and functional integration into the gnathostomatic apparatus. While it may not impact on the $4 billion a year whitening arena of oral services, it will impact on many others. The number of rubber dam hazard articles may well breach the levees and flood- gates and overwhelm the profes- sion, decimating the landscape and relocating the populace. It is Oral Health’s job to stand on guard: “Oh Canada, to stand on guard for thee”. DT References 1. Neiburger EJ. Similar mandibular os- seous lesions in Tyrannosaurus rex and man. J Mass Dent Soc. 2005 Fall;54(3):14–7. 2. Neiburger EJ. Voodoo Barbie and the dental office. N Y State Dent J. 2001 Jun- Jul;67(6):26–7. 3. Neiburger EJ. Water line biofilm dangers a tempest in a teapot. J Mass Dent Soc. 2001 Winter;49(4):20–1. About the author Dr Kenneth S. Serota graduated from the University of Toron- to in 1973 and was awarded the George W. Switzer Memorial Key for Excellence in Prosthodontics. He received his Cer- tificate in Endodontics and Master of Medical Sciences degree from the Harvard-Forsyth Dental Center in Boston. A recipient of the American Association of Endodontics Memorial Research Award for his work in nu- clear medicine screening procedures related to dental pathology, his pas- sion is education, and most recently e-learning, and rich media. Dr Serota provided an interactive endodontic programme for the Ontario Dental As- sociation from 1983 to 1997 and was awarded the ODA Award of Merit for his efforts in the provision of continu- ing education. The author of more than 60 publications, Dr Serota is on the editorial board of Endodontic Practice, Endo Tribune and Implant Tribune. He founded ROOTS, an on- line educational forum for dentists from around the world who wish to learn cuttingedge endodontic therapy, and recently launched IMPLANTS (www.rximplants.com) and www.td- sonline.org in order to provide den- tists with a clear understanding of the endodontic–implant algorithm in foundational dentistry.